At the completion of my first book of which this is the companion of, I had just transferred back to my original Valley System Hospital. My boss at the Henderson Hospital had warned me in my exit interview that you can never go back. She said that things will never be the same. How right she was in making this statement. I don’t know if it was the pandemic that changed things or the fact that so many people had left after I made the transfer and even more were still leaving. Many giving reasons of burnout that caused things to be so different. I know one thing, I have never seen so many young nurses getting burned out before. It usually just happens to old veterans not nurses with just a few years nursing under their belts. I think, part of the reason was greed that caused this burnout. Because of the excess demand produced by the pandemic, nurses could make almost unlimited amounts of money. The possible paydays were quite large and nurses could make up to $2,000 a day for a twelve hour shift. One of my fellow nurses made over $600,000 in 2020 and part of 2021 working in New York State. To do this, he worked 6 days a week for a period that covered one calendar year with no time off. But he had a goal in mind, he wanted to pay off the mortgage to his house. He was successful and is now sitting in the cat birds seat with virtually no bills. He is one of the few that survived without getting burned out. He did this by shear will power alone. While I haven’t asked the nurses that left if they picked up a lot of overtime, I really don’t have to. I already know the answer because I have two eyes and two ears and I watched and listened to them talk. I know they were working crazy hours. I am one of the few people that picked up absolutely no overtime in 2020 and I only agreed to pick up a fourth day for an eight week period due to a $15,000 bonus being offered. That was the only time that I picked up any overtime during the pandemic.

You may ask why I did this? I did it for several reasons… over the last fifteen years I have made over six figures a year. The more money I made the more money I spent. While I got to do a lot of traveling and bought a lot of nice toys, financially, I was no better off. I was still in debt after all that time. When I talk to new nurses, I give them all the same advice, live within your means. Only pick up that fourth day to attain short term goals. Do not do it to live your daily life because if you do so, you will most assuredly get burned out. The vast majority of them are starting with nursing being their first career right out of high school and college. This means that if they stay in nursing their whole career they will be in that field for possibly 50 years. That is a long time to be doing something, especially if you are locked into working overtime the vast majority of the time.

A second reason for not picking up overtime was my health. I am not sure if the reader is medically inclined or is aware that the COVID-19 virus is unique in the respect that it seems to key in on several types of victims. It picks on people over 50. It picks on people that are obese. It picks on people that suffer from hypertension. It picks on people who are diabetics. It picks on people who suffer respiratory ailments. And finally, it picks on people with high blood levels of cholesterol and triglycerides. Of these factors that I have listed, I have four of them. Initially, people that met some or many of these criteria and became seriously infected mostly died. They seem to die no matter what the doctors did to treat them. Initially there were no effective treatment modalities mainly because some of the likely treatments were blocked from being used. But irregardless of the reasons for these failures, dead people cannot spend money and I valued my life more than a paycheck.

The third reason I did not want to pick up extra hours was due to the difficulty of the work. I was just too physically and mentally exhausted after working my three days a week. For at least the first eight months of the pandemic, I took care of three positive COVID patients, most of who were on multiple intravenous medications and were on respiratory support. We were so busy that most of the shifts we worked we did not get breaks at all…there just was no time. I want you to remember that nurses and many other medical staff members work twelve hour shifts. If you are used to working a five 8-hour a day week, think of adding four more hours to that shift and not getting time to catch your breath. We ate as we charted on our patients with even that time being interrupted by patient care issues.

The fourth reason was that the more days you worked the more people you saw die. In one 24-hour period the hospital I worked in had eight patients die of COVID. That hospital had only 150 beds. That, by todays standards is considered to be a fairly small hospital. In one night, five patients died on one of my shifts. Each of those patients had to be coded. A code typically takes almost a third of the staff off the floor to revive that patient. It also takes typically from 30 to 45 minutes. So now the over-burdened nurses are having to watch even more patients as their co-workers futilely try to save these patient’s lives. Even if they are revived one or even two times, they will just code again until they can no longer be revived. This was our world for close to 18 months.

It may seem like I have covered subject matter reserved for my next chapter and you would be right in this assumption. The problem is that it is hard to separate your life from your career especially if that career is the driving purpose of your life. I do not fall into that category, yet I still fell into the trap. It is pretty hard to separate the two because we spend so much of our lives working. I have been working in some job or other for over 40 years. During this time I have worked either overtime, had two jobs, went to school full-time, or had a business on the side for a substantial portion of that time. Frankly, I am tired of working. I am also overweight which means that it takes more energy for me to do my job. Even the act of walking and bending and squatting or kneeling is taking more effort. When I get home from work even after a relatively easy night, I am exhausted. So after seven months at my old hospital, I had no choice but to give my notice. I took two months off while I recuperated and fought the effects of PTSD. I will devote a separate chapter to this ongoing struggle.

I want the reader to know that this basic leave of absence was not in any way planned. I did not have any money put away for it. The only thing that saved me was that I had over 300 hours of PTO built up. This windfall kept us solvent for those two months. During this time, I did a lot of thinking about where I wanted my career and life to go. Connie and I discussed our options, we even considered moving one more time. As a matter of fact, this might still become an option. One thing I discovered in writing not only my first book but my second as well, is how much I missed out on with moving out west. Even though I love the west, I have missed out on so many family events that I frankly have lost track of them. Five of my closest relatives have passed away during the 20 years that I have lived in Las Vegas. Those are moments in my life that are lost forever. I only have one remaining sibling and both of our parents have passed away. My sister also lost her spouse of whom she was married to for 50 years. Life is truly hard and the only thing that is constant is family. Friends come and go while family is truly forever. One good thing that has come from my writing, is that I have been in contact with several of my family members while doing research for the various chapters of my second book.

When I met Connie, I weighed just around 200 lbs. As has happened in my first two marriages, I gained weight after I got married to Connie. However, in my first two marriages I was able to lose the weight I initially gained. This time I can’t seem to lose that weight. What is different this time is that I have gained enough weight that it is actually affecting my health. I am now on two blood pressure medications and I am pre-diabetic as well. My cholesterol and triglyceride levels are also high, though I cannot tolerate taking the Simvastatins to reduce these elevated levels. They not only cause me to be in constant pain, they adversely affect my long term memory as well. This is not a good thing for someone who has people’s lives in his hands on a daily basis. While it is no secret that I have been no fan of bariatric surgery over the years, I have come to the realization that this may be my only hope. In the last few weeks, I came across an old acquaintance while at work. She works for Quest Diagnostics and makes nightly rounds to draw labs for our patients. I almost did not recognize her to be honest until she started talking to me. I did in fact not recognize her! The reason for this was that she had lost one hundred pounds. I asked her how this was possible and she told me that she had bariatric surgery. She also informed me that it was the best decision she had ever made because her excess weight was affecting her health as well. Even though she can no longer eat big meals, she has come to grips with this. She eats frequent small healthy meals. When she goes to restaurants, she now always takes a doggy bag back home with her and she skips the deserts offered by the restaurants she frequents.

After talking with my co-worker, I shelved the conversation in the back of my mind that is until I started getting short of breath when doing walks around the neighborhood with my wife. I also started thinking back to a comment made by a friend of mine when we visited him and his wife in Kansas a few years ago. He said that I was breathing very loudly, something he never noticed me doing when he previously lived in Las Vegas. So I talked to my wife and decided to take the plunge. Of course, nothing goes smoothly. I couldn’t have made this decision before I left my last job. My insurance then covered that surgery. The insurance I have with my new job does not cover it at all. I asked the medical group that I decided to use for the procedure if they took payments and they said no. So I contacted my bank and much to my surprise, I qualified for a personal loan for the total amount of the procedure. The only problem is that I do not have enough PTO to cover the four weeks I will need to take off from work. So now I have to scrimp and save to get by yet another lean month. To cover the lost income I will pick up some overtime over the next four weeks before I have the surgery. I was lucky that my boss agreed to give me a leave of absence for the procedure. He can empathize with my situation because he is my age and is also struggling with weight loss issues as well.

I have been watching my required videos and have downloaded my workbook and log. In two weeks, I am going to have to reduce myself down to a spartan diet of two protein shakes and a lean protein meal to help my body acclimate to the new dietary regimen mandated by my surgery. I want my reader to know that I am not taking this decision lightly. It is one of the hardest things I have had to do. Once I have this surgery there is no going back because it is permanent. I have opted to have the simplest and most popular technique, the gastric sleeve procedure, also termed Sleeve Gastrectomy. The procedure involves using lap incision sites being made in your abdomen and the removal of part of your stomach through those same incision sites. This procedure reduces the volume of food that you can eat at one time, it does so by shrinking the size of your stomach which makes you feel full quicker.

Figure 1. Gastric Sleeve

I know, the procedure looks pretty scary. However, they have come a long way from the surgical techniques that were used on my Aunt Alida over 45 years ago. She was also morbidly obese and opted for the surgery as have I. Something I hope I will not have a problem with was that she was always having problems with nausea and vomiting. I think that the main reason for all of her problems was that the support for the procedure back then was not extant. I also think she had more problems is that she had a gastric bypass procedure, which is less popular now, since the advent of the gastric sleeve procedure. One thing I know even though she experienced some problems she did lose a lot of weight. There is also one thing that I found out by talking to her as a pre-teen, is that she had no regrets. She had no regrets, because overall it changed her life for the best. The major reason that I am having this procedure is that I want to be able to enjoy a long and fruitful life with my wife. She is very healthy and energetic and I want to be able to keep up with her in both her daily and outdoor activities. Even though I will have completed this book before I have the procedure, I will keep those interested up to date via my blog, http://www.common-sense-in-america.com in the section “The Bloggist” and in my podcast “Common Sense And Ramblings In America”.

In case you are wondering the procedure will cost me $18,500, of which 100 percent will be out of pocket. Thank you Mr. Insurance Company.